title: Safety profile of hymenoptera venom immunotherapy (VIT) in monosensitized patients: lack of new sensitization to nontreated insect venom.
abstract: BACKGROUND
  Venom immunotherapy (VIT) has proven to be efficacious in reducing the severity of anaphylactic reactions following field stings in patients with Hymenoptera venom allergy. Due to sequence homologies in the allergens used in Hymenoptera vaccines, there is concern that immunotherapy could lead to sensitization to allergens to which patients were not previously sensitized. The relevance of such an undesired phenomenon is unclear.
  
  
  OBJECTIVE
  To investigate the incidence of sensitization to Hymenoptera venoms other than those to which the patients were already sensitized and to assess the overall safety profile of VIT in order to compare the risk-benefit ratio in a subpopulation of monosensitized individuals.
  
  
  METHODS
  We performed a retrospective analysis of specific immunoglobulin E (sIgE) levels in patients with no prior detectable sIgE to Hymenoptera venom other than the one for which they received VIT. We assessed the safety profile of VIT using serological and clinical parameters.
  
  
  RESULTS
  Of the 56 monosensitized patients who had VIT, 3 (5%) developed sIgE to the other insect with no history of field sting to explain it. This rate was similar to the rate of new sensitization due to field stings during VIT. VIT was well-tolerated and levels of serological markers improved. No patient had a systemic anaphylactic reaction after having been stung by an insect other than the one he/she was desensitized for during follow-up.
  
  
  CONCLUSIONS
  VIT seems to be safe with respect to clinically significant new sensitizations.
authors.affiliation: Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland. spoerld@uhbs.ch
authors.forename: D
authors.initials: D
authors.lastname: Spoerl
authors.forename: A J
authors.initials: AJ
authors.lastname: Bircher
authors.forename: K
authors.initials: K
authors.lastname: Scherer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology* / Q000627:therapeutic use; D000707:Anaphylaxis / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D000818:Animals; D000918:Antibody Specificity; D001514:Bee Venoms / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D003888:Desensitization, Immunologic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D015994:Incidence; D007279:Injections, Subcutaneous; D007299:Insect Bites and Stings / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013557:Switzerland; D014862:Wasp Venoms / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000485:Allergens; D001514:Bee Venoms; D014862:Wasp Venoms; D007073:Immunoglobulin E